Rebirth of a Doctor Without Regrets

Chapter 102 Terrible Mold

Li Wei was holding a pre-cut pericardial flap, trying to attach it to the artificial valve ring, while Zhu Chunhua helped adjust it.

However, both of them were a bit clumsy, and the edges of the cut pericardial pieces were not neat enough, nor did they fit the artificial valve ring tightly enough.

The two had to repeatedly adjust the angle for each stitch, as the stitches could easily shift if they weren't careful, and they even almost punctured the thin pericardial tissue.

Wang Xiao couldn't help but recall the time when Shen Hao assisted him with valve reconstruction during his last surgery.

Shen Hao can precisely control the fit between the pericardial patch and the artificial valve ring with just his fingertips. The stitches are even and fine, and even the slightest adhesion can be dealt with quickly.

In comparison, the difference between Li Wei and Zhu Chunhua's performance and Shen Hao's is like night and day.

But Wang Xiao also knew very well that they couldn't be blamed for this.

External valve reconstruction is an unconventional procedure, far more complex than performing it in situ within the heart.

Standard valve reconstruction uses the patient's own heart as a mold, resulting in a natural and precise fit. The procedure can also be adjusted according to the internal anatomical structure of the heart during the operation.

For ex vivo reconstruction, the pericardial patch can only be forcibly attached to the artificial valve ring, using this artificial valve ring as a temporary mold.

Moreover, this artificial valve ring is not a real valve orifice at all; its function is merely to provide an auxiliary ring-shaped stent for patients whose valve orifices are enlarged and whose leaflets are loose, leading to incomplete closure.

Its function is to tighten the valve opening and fix the valve leaflets.

The biggest problem with using it as a mold for artificial valves is that it is extremely easy to slip.

The pericardial film is soft, while the artificial valve ring is smooth and has no adhesion. If you adjust the stitches with a little force, the two will become misaligned.

Ensuring a tight fit of the pericardial patch while preventing the mold from slipping increases the difficulty exponentially.

As a technique, the lower the skill level required of the operator, the better.

After all, the fundamental purpose of developing a surgical procedure is to save patients, not to demonstrate how amazing the surgeon is.

The best surgical procedure is one that a resident can easily perform and resolve major issues with.

Wang Xiao didn't delay any longer and turned to focus on the heart in the surgical field.

He held the tissue scissors and carefully peeled the artificial flap from the fibrous tissue that was calcified and hardened, and could tear the surrounding myocardium with the slightest force.

Li Wei's movements gradually became more stable, but the progress was still slow.

Wang Xiao removed the leaking artificial valve leaflet and then gradually peeled away and removed the severely calcified original valve opening.

Those grayish-white calcified plaques piled up layer by layer, penetrating deep into the annulus valve.

Each small piece peeled off must be carefully inspected for any residue or damage to the blood vessels around the valve annulus.

When Wang Xiao finished cleaning the surgical field and removed the excised calcified tissue and damaged artificial flap, she turned to look at Li Wei and found that Li Wei had only finished suturing half of the artificial flap.

If a new valve opening cannot be sutured onto the patient's heart immediately after the resection, then this new surgical variation is meaningless.

Perhaps rebuilding the valve directly on the heart would be faster.

The time his heart stopped beating was gradually increasing; the old man's heart muscle simply couldn't withstand prolonged ischemia and hypoxia.

It seems that this variation of the procedure requires a genius-level assistant to keep up with the surgeon's speed, or in fact, the requirements for the assistant are even higher than those for the surgeon.

Wang Xiao picked up another pre-cut pericardial patch and suture needles, and walked to the opposite side of Li Wei: "I'll suture from the opposite direction with you. Let's speed things up; we can't delay any longer."

A hint of guilt appeared on Li Wei's face. She quickly nodded and adjusted her position to match Wang Xiao's rhythm.

With the two of them on either side, the progress was much faster.

However, Wang Xiao also felt that the pericardial tissue kept sliding, making suturing very difficult.

He couldn't help but think of his former employer, who had a very popular stapler, also known as a surgical suture nail gun, which was often integrated into laparoscopy.

That thing can sew and fix an entire edge in one go with just a light tap and a click, it's stable and neat, unlike now, where it's being tormented by the slippery pericardial sheet.

If a mold could be developed that integrates this anastomosis device, and then divided into several areas, with a fixed-size pericardial patch attached to each area, and then stapled together by pressing once, wouldn't that be much more efficient than stitching and piecing things together bit by bit by yourself?

In cardiopulmonary bypass surgery, time-saving tools can improve patient survival rates and prognosis.

As Wang Xiao looked at the gradually forming artificial flap, he vaguely sensed that something was amiss.

An hour later, the two finally completed the creation of the artificial flap.

Wang Xiao picked up the new size 22 artificial flap, carefully adjusted its position, and quickly and precisely sutured the artificial flap to the reconstructed flap outside the body.

A water injection test confirmed that there was no leakage.

"Prepare to insert the valve orifice into the heart, align it with the original valve ring position, and prepare to suture," Wang Xiao instructed.

Li Wei immediately stepped forward to assist, carefully and gently inserting the artificial valve orifice with the artificial valve into the original valve ring of the heart.

Just as Wang Xiao reached out, trying to align the artificial valve with the original heart valve, his movement suddenly stopped.

He repeatedly adjusted the position, trying to fit the artificial valve in place, but no matter how he adjusted it, the outer diameter of the artificial valve was obviously too small, leaving a tiny gap between it and the heart, making it impossible to fit tightly.

Wang Xiao's expression instantly turned serious, and a hint of panic flashed in his eyes.

He suddenly remembered the sensation when he peeled away the calcified lesions and instantly understood the problem.

When the original flap was removed, the calcification was much thicker and deeper than expected, so he subconsciously increased the depth of dissection and resection.

Unbeknownst to them, too much valve tissue was removed, and the artificial valve they reconstructed according to the original specifications naturally appeared too small on the outside.

Li Lei, standing in the corner, also sensed that something was wrong. He stared intently at Shu Ye, barely daring to breathe, a sense of foreboding rising in his heart.

If it cannot be properly sewn together, and leakage occurs after insertion, the consequences would be unimaginable.

Zhu Chunhua and Li Wei were also stunned, their faces turning deathly pale. They were at a loss for what to do and could only stare blankly at Wang Xiao.

Wang Xiao tightened his grip on the equipment, forcing himself to calm down.

Don't worry, I have a cheat code.

The surgery had been going on for more than three hours, and cardiopulmonary bypass had been maintained for two and a half hours.

The old man's heart muscle had begun to show slight edema, and there was no time left to remake the artificial valve.

Wang Xiao's mind raced through various possible solutions, but this was the first time he had encountered such a situation.

Zhu Chunhua stood beside him and said gently, "Don't panic, there's still a chance. Let's use the pericardium plasty to thicken the outer diameter first."

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